Introduction of the day case total laparoscopic hysterectomy (TLH) protocol

Abstract

Background Traditionally total laparoscopic hysterectomy (TLH) patients are admitted for 1–2 days post‐operatively. Day case TLH has been proven to be feasible and safe in other countries; however, this tertiary Queensland hospital is one of the first Australian institutions to introduce a day case TLH protocol. Aim To pilot the implementation of our day case TLH protocol assessing the feasibility, safety and patient satisfaction of same‐day discharge. Materials and Methods A retrospective audit of the implementation of our day case TLH protocol at a tertiary Queensland hospital was conducted. Primary outcome was length of post‐operative hospital stay. Secondary outcomes included perioperative complications and post‐operative re‐presentation rates. Patient satisfaction was assessed through a patient questionnaire. Results Seventy‐seven patients were included in the study. There were 94.81% patients who went home on the same day. Their average length of post‐operative hospital stay was 7.72 (SD ± 3.36) hours. Of the patients who did achieve same‐day discharge, the average length of stay was 7.05 (SD ±1.46) hours. There were no significant differences in perioperative complications or re‐presentation rates compared to previously published literature. Patients reported they were extremely satisfied with day case TLH. Conclusion The implementation of our day case TLH protocol is feasible, safe and well received by patients in our tertiary Australian hospital. These results can have multimodal effects in healthcare: decrease in hospital costs by reducing length of stay and overnight admissions, improved theatre efficiency and patient flow, while maintaining patient safety and satisfaction.

Stress response and safety of lidocaine combined with dexmedetomidine in patients undergoing laparoscopic hysterectomy

“…Laparoscopic total hysterectomy is highly favored by women who wish to undergo total hysterectomy because of its minimal impact on the patient's ovarian function, minimal invasiveness, and rapid postoperative recovery [1]. Previous clinical studies have found that the choice of perioperative anesthesia protocol not only affects the anesthetic effect but also effectively reduces the occurrence of postoperative cognitive dysfunction, and improves the overall quality of life of patients [2]. As a result, improving the anesthetic regimen in laparoscopic complete hysterectomy has become a focus of clinical studies in recent years.…”